[Kidney procurement and transplantation from a surgical perspective]

Area of Science:

• Nephrology
• Transplantation Surgery
• Immunology

Context:

• End-stage renal disease (ESRD) necessitates renal replacement therapy.
• Kidney transplantation is the optimal treatment for ESRD, surpassing dialysis in lifespan extension.
• Organ donor shortage leads to prolonged waiting times for deceased donor kidneys, averaging four years in Germany.

Purpose:

• To highlight the advantages of kidney transplantation, particularly from living donors.
• To discuss the optimization strategies for living donor kidney transplantation.
• To underscore the factors contributing to excellent long-term transplant outcomes.

Summary:

• Living donor kidney transplantation offers reduced waiting times (weeks vs. years) and superior transplant quality due to optimized preparation and short cold-ischemia times.
• Pre-emptive living donor transplantation, avoiding dialysis, is a viable option for both adults and children.
• Improvements in surgical techniques, organization, donor/recipient care, and immunosuppression have driven excellent long-term results.

Impact:

• Living donation significantly improves patient outcomes and quality of life for ESRD patients.
• Optimized protocols for living donor transplantation can mitigate organ shortage challenges.
• Advances in transplantation science continue to enhance graft survival and patient longevity.